Wasteful spending occurs, for instance, when patients are harmed in the process of care, receive interventions that are not medically indicated, use brand-name drugs instead of generics, or are unnecessarily treated in a hospital instead of a more suitable lower- level facility. Countries could potentially spend significantly less on healthcare with no impact on health system performance, or on health outcomes.

Agnes’ keynote focuses on a recent report by the OECD that systematically reviews strategies put in place by countries to limit ineffective spending and waste. Actions to tackle waste are needed in the delivery of care, in the management of health services, and in the governance of the system. Acknowledging the existence of wasteful spending and collecting more systematic information on its scope are necessary steps.

Tackling waste requires persuading all stakeholders that the best option is the least wasteful one, and developing payment and incentives that reward the delivery of the right care in the right place.

Liza Corso and Robert Blake discuss the benefits from cross-jurisdictional sharing of essential public health services and offer examples of successful collaboration from around the nation. Liza Corso and Robert Blake discuss the benefits...